Telehealth usage soared during the earliest phases of the COVID-19 pandemic out of sheer necessity, but its potential as an integral component of modern medicine was capably demonstrated years earlier. Now that patients and physicians alike have voiced overwhelming support for virtual care, it is time for the health insurance industry to extend coverage parity for services, whether they are delivered in person or via telehealth. Failing to do so needlessly places the future of telehealth at risk.
The AMA firmly supports coverage parity that requires payers to cover a service via telehealth if it is also covered in-person and can be delivered remotely while meeting the standard of care. The AMA also supports fair and equitable payment requirements that are applied in a uniform way across the full range of clinical services. Payments should be fair and equitable, regardless of whether the service is rendered through audio-only means, an audio-video hookup, or in person.
More than 40 states have a telehealth coverage parity law on the books and many have implemented payment parity, but much more work needs to be done. It is interesting to note that prior to the COVID-19 public health emergency, only 10 states required payment parity. Twenty-one states now permanently require payers to implement payment parity for all telehealth services, while eight more have adopted similar policies with caveats (such as for specific specialties only).
Promoting telehealth expansion
Telehealth helps physicians serve patients’ needs in a comprehensive and cost-effective manner. That’s one of the reasons the AMA emphasizes support for telehealth as one the five pillars of our Recovery Plan for America’s Physicians, and why we are constantly working to ensure physicians have the tools, research and resources they need to seamlessly integrate this technology into their practices.
Telehealth allows physicians to boost continuity of care by extending access outside of normal clinic hours. Telehealth can also lessen the impact of physician shortages among underserved populations. as well as in rural areas. Plus, this technology can help physicians better manage heart disease, diabetes and other chronic illnesses among their patients, and help dissuade patients from delaying care for conditions that might otherwise result in emergency department visits, hospital stays or worse if left undetected. Telehealth boosts communication between patients and physicians and strengthens the trust found at the center of that relationship.
Earlier this year, the AMA House of Delegates addressed the need for greater equity in telehealth by adopting policy to expand digital literacy and strengthening efforts to reach members of historically marginalized and minoritized communities. The AMA Future of Health Immersion Program and our Telehealth Implementation Playbook are just two of the many free resources we offer online to help physicians broaden and optimize telehealth services through peer-to-peer training and other methods.
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Before the COVID-19 pandemic, Medicare paid for only a limited number of telehealth services, and did so only for patients who resided in rural areas and who had traveled to a medical facility to receive them. The AMA led the fight to lift these and other limits so that patients nationwide could access telehealth services, and receive them in their own homes. A 2021 survey showed that 85% of responding physicians use telehealth services.
When the federally declared COVID-19 public health emergency expired in May, it ensured that new policies that promoted telehealth expansion would remain an AMA priority. Our advocacy helped secure passage of federal legislation that extended pandemic-related telehealth flexibilities through 2024. Currently, we are supporting the CONNECT for Health Act of 2023, a bipartisan proposal now pending in Congress that would make Medicare’s pandemic-related flexibilities permanent.
Telehealth has become an essential element of health care delivery today, and coverage and payment of services via telehealth must be part of that equation. The time has come to ensure that payers fully recognize the vital role this technology plays by ensuring coverage parity as well as fair and equitable payment for telehealth services. The AMA is committed to a health system in which patients have routine access to remote care, and physicians are properly compensated for our time and expertise in delivering that care.
